| NPI | 1093344772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 77946) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP61560397) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2025-09-09 |